After 14 years of working in Kurram district, in the Federally Administered Tribal Areas (FATA), Pakistan, Médecins Sans Frontières (MSF) is withdrawing from the area. The authorities have refused to issue a no objection certificate (NoC), without providing any explanation. Without a valid NoC, MSF cannot continue to provide medical services in Kurram Agency, which is located on the north-western border of Pakistan.

“MSF is saddened by the decision from the authorities responsible for NGOs working in Kurram Agency. The closure brings to an end 14 years of MSF working with the FATA Health Services in Kurram Agency,” said Catherine Moody, Country Representative for MSF in Pakistan.

MSF has informed its team in Kurram Agency, the elders of the district’s towns Sadda and Alizai, and the local community about the decision.  The necessary measures to end MSF's health services in Kurram Agency have started, and should be completed by the end of the week.

MSF teams have been working in Kurram Agency since 2004, and have been present in Sadda and Alizai hospitals since 2008.

In Sadda hospital, MSF has been responsible for the outpatient department for children under the age of five and the inpatient department for severely ill children up to 12 years old. The neonatal unit treats babies born prematurely and those experiencing complications immediately after birth. The team also facilitates emergency referrals to tertiary care hospitals by providing ambulance services and medical transfer staff.

MSF has been supporting the Ministry of Health maternity department by managing emergency transfers to maternity facilities, including to MSF’s Peshawar Women’s Hospital. MSF provided the ambulances and all medical support required during the transfers. In addition, MSF provides diagnosis and treatment facilities to the community for leishmaniasis, immunisation for children, as well as supporting the Ministry of Health and Federal Disaster Management Agency in responding to emergencies, disease outbreaks and mass casualties.  In Alizai, MSF is responsible for the outpatient department and observation room for children under 12 years.

In 2016, MSF teams carried out 36,498 outpatient consultations in Sadda, and 6,416 consultations in Alizai. The same year, Sadda hospital admitted 1,946 patients and treated 414 patients for cutaneous leishmaniasis, while  a total of 736 newborns were admitted to the neonatal unit.

MSF continues to provide free outpatient, emergency and maternal healthcare in Bajaur Agency in FATA, as well as giving medical care in Khyber Pakhtunkhwa, Sindh and Balochistan provinces. MSF relies solely on private financial contributions from individuals around the world and does not accept funding from any government, donor agency, or military- or politically-affiliated group for its activities in Pakistan. MSF has been working with Pakistani communities affected by natural disaster, conflict or lack of access to healthcare since 1986.